Insurance, Coverage, and Costs: April 13, 2023

ER’s Error Lands a 4-Year-Old in Collections (For Care He Didn’t Receive)
By Daniel Chang A Florida woman tried to dispute an emergency room bill, but the hospital and collection agency refused to talk to her — because it was her child’s name on the bill, not hers.

Two Counties Square Off With California Over Mental Health Duties
By Angela Hart The state wants to stop paying Kaiser Permanente for treating severely mentally ill Medi-Cal patients in Sacramento and Solano counties and force the counties to take on the task. The counties’ leaders say they can’t afford it.

A Progress Check on Hospital Price Transparency
By Michelle Andrews Hospitals are facing mixed reviews regarding their efforts to comply with a federal requirement that they post information about prices related to nearly every health care service they provide.

Truly Random Drug Testing: ADHD Patients Face Uneven Urine Screens and, Sometimes, Stigma
By Arielle Zionts Doctors have no national standards on when to order urine tests to check whether adult ADHD patients are properly taking their prescription stimulants. Some patients are subjected to much more frequent testing than others.

For Uninsured People With Cancer, Securing Care Can Be Like Spinning a Roulette Wheel
By Charlotte Huff When uninsured people are diagnosed with cancer, accessing resources and paying for treatment can be daunting. The safety nets meant to help often fall short, say cancer physicians and health policy experts who study access to care. Some patients find it easier to play the odds.

Health Providers Scramble to Keep Remaining Staff Amid Medicaid Rate Debate
By Keely Larson The ranks of community-based behavioral health providers in Montana have diminished amid rising costs, greater need, and stagnant Medicaid reimbursement rates. Now, as state lawmakers debate solutions, providers are hoping just to cover their costs.

Obamacare at 13: Biden and a KHN Reporter Remember
By Phil Galewitz The White House gathered the people who helped pass the Affordable Care Act 13 years ago — partly to congratulate themselves but also to emphasize that they still have much work to do to make health care affordable.

Montana May Require Insurers to Cover Monitoring Devices for Diabetes
By Keely Larson Montana is one of several states considering expanding coverage of continuous glucose monitors, but insurance companies and some providers argue that not all people with diabetes need them.

In Texas, Medicaid Coverage Ends Soon After Childbirth. Will Lawmakers Allow More Time?
By Elena Rivera, KERA Pregnancy-related Medicaid coverage ends just two months after childbirth in Texas — some advocates and researchers say that cutoff contributes to maternal deaths and illnesses in the state.

An Arm and a Leg: A Doctor’s Love Letter to ‘The People’s Hospital’
By Dan Weissmann Could a charity hospital founded by a crusading Dutch playwright, a group of Quakers, and a judge working undercover become a model for the U.S. health care system? In this episode of the podcast “An Arm and a Leg,” host Dan Weissmann speaks with Dr. Ricardo Nuila to find out.

The Big Squeeze: More Enrollees and Smaller Networks Plague Some ACA Plans
By Julie Appleby Despite record enrollment in health insurance plans under the Affordable Care Act, some consumers who bought coverage and agents who helped them do so have had a tough start to the new year: Many say it’s hard to find an in-network doctor or hospital.

KFF Health News' 'What the Health?': A Judicial Body Blow to the ACA
A federal judge in Texas has dealt a big setback to the Affordable Care Act. The same judge who tried in 2018 to declare the entire ACA unconstitutional has now ruled that the law’s main provisions for preventive care are unconstitutional and, therefore, unenforceable nationwide. Also this week, North Carolina became the 40th state to expand Medicaid under the ACA. Alice Miranda Ollstein of Politico, Rachel Cohrs of Stat, and Sandhya Raman of CQ Roll Call join KHN chief Washington correspondent Julie Rovner to discuss these issues and more.

Judge’s Decision Would Make Some No-Cost Cancer Screenings a Thing of the Past
By Julie Appleby and Michelle Andrews A U.S. District Court ruling overturned the section of the Affordable Care Act that makes preventive health services — from colonoscopies to diabetes screenings and more — available at no cost to consumers.

High Inflation and Housing Costs Force Many Americans to Delay Needed Care
By Stephanie Colombini, WUSF A recent Gallup Poll suggests that Americans are putting off medical care because of costs. Inflation and rising rents make it harder for people to make ends meet.

Special Medicaid Funds Help Most States, but Prompt Oversight Concerns
By Andy Miller Georgia is among 35-plus states that have used an under-the-radar federal funding mechanism to boost payments for hospitals and other providers under Medicaid. But a government watchdog and a congressional advisory commission say sparse oversight makes it hard to tell if the “directed payments” program is meeting its goals.

Journalists Discuss Medicaid Unwinding and Clawbacks
KHN and California Healthline staff made the rounds on national and local media this week to discuss their stories. Here’s a collection of their appearances.

Decisión de un juez haría que algunas pruebas de detección de cáncer sin costo fueran cosa del pasado
By Julie Appleby and Michelle Andrews La decisión podría afectar los exámenes de detección sin copago y servicios preventivos similares que la mayoría de los estadounidenses con seguro tienen como parte de sus planes de salud.

Para pacientes de cáncer sin seguro, conseguir atención médica es una lotería
By Charlotte Huff Los estudios demuestran que, a veces, los adultos sin seguro retrasan la atención, lo que puede perjudicar las probabilidades de supervivencia. Pero que los pacientes obtengan un seguro para cubrir el tratamiento se parece un poco al juego de la ruleta, es decir, depende de dónde vivan y del tipo de cáncer que padezcan.